Individual provider Active NPI

Israr Shah

  • Internal Medicine Physician
  • Torrington, CT
National Provider Identifier
1790219285
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
071025 Issued in CT
Practice address
540 Litchfield St
Torrington, CT 06790-6679
Phone
(860) 496-6666
NPI assigned
Apr 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 071025 CT Primary

Addresses

Primary practice location

540 Litchfield St
Torrington, CT 06790-6679

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-9093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200604001366 NY Practitioner - HospitalistPractitioner - Internal Medicine 6507287265
I20220713002652 CT Practitioner - Internal Medicine 6507287265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
The Charlotte Hungerford HospitalGroup PAC ID 4486557501, 206 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-6000

540 Litchfield St
Torrington, CT 06790-6679
Phone (860) 496-9669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
071025CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 1, 2023 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Jul 1, 2022 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Jul 1, 2022 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: israr.shah@xdr.hhchealthdirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1790219285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LITCHFIELD ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906679",
            "telephone_number": "860-496-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ISRAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "071025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.